Jeff Crouse sits on the couch in his trailer outside of Thomasville and ponders his situation.

“It’s just like something has gone horribly awry in the universe,” he said. “Something’s gone horribly awry, and I don’t know what.”

As he sits there, he and his wife Judy of 25 years are looking at a folder telling the tale of the last few years, a tale that has given Judy a reoccurring nightmare that she’s sitting outside their home surrounded by boxes.

It’s a common tale, one that we’ve heard with numbing repetition. Yet, it is a tale of our time, about how difficult it is to overcome a health crisis, how an encounter with the health care system can leave people wondering whether they’re going to come out of it with a roof over their head.

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Jeff and Judy Crouse have been grappling with staying ahead of medical bills after Jeff had a heart attack. They are concerned they may lose their home.(Photo: Mike Argento, York Daily Record/Sunday News)

It began five years ago. Jeff was on the job – he's a licensed HVAC tech – when he was having trouble catching his breath. He described the sensation as like being underwater and trying to break the surface to catch a gulp of air. At the same time, it felt as if someone or something was clutching his heart and squeezing it. He was having a heart attack.

Long story short, his company called an ambulance and he wound up in the hospital, where doctors inserted two stents in the arteries feeding blood to his heart.

He came out of it OK. He had insurance and it was covered. But not long after his heart attack, he had to leave that job. The stress, he said, was too much, and coupled with the doctor’s orders not to do any heavy lifting or strenuous activities, such as humping air conditioning units to the sides of buildings or removing furnaces, he felt he had to go.

That led to a series of jobs, some lasting longer than others, but most not very long. It was difficult to get a job at his age, for one thing, and for another, he had to tell prospective employers about his health issues and how they might limit his ability to do certain aspects of the job.

He found himself going long stretches when he didn’t have health insurance to cover his doctor visits and medications. He couldn’t afford health insurance, and since Judy was, and is, retired – she's 10 years older than him, at 70 – he couldn’t get covered under her Medicare.

He skimped on medication. Some of the prescriptions, without insurance to help pick up the tab, ran close to a $100 a month. Instead of filling those prescriptions, he turned to using over-the-counter supplements and vitamins, which really didn’t do the kind of chemical heavy lifting that pharmaceuticals can do.

In May 2017, he had just started a new job, working as a maintenance person at an apartment complex, when, one day, he felt a familiar sensation – the inability to breathe, the constriction in his chest, the light-headedness that made him feel like he was about to keel over. He was having another heart attack. His office called an ambulance, and he wound up back in Memorial Hospital.

This time was different. Because he hadn’t passed the 90-day mark on the job, he didn’t have health insurance. Of course, the hospital wasn’t going to kick him to the curb and not treat him. The health-care professionals were just that — professional and caring.

He recovered, mostly. He still has some issues with his heart and has to be careful.

But then the bills arrived. All totaled, he and Judy were looking at about $30,000 in bills. Memorial did knock $13,013 off the bill after they wrote a letter asking for some relief, a letter Judy described as “the begging letter.” They had no money. Jeff was unemployed again. Judy’s Social Security wasn’t enough to keep up with any payments and still pay the bills.

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This is just one of the bills that Jeff and Judy Crouse have had to deal with since Jeff's heart attack.(Photo: Mike Argento, York Daily Record/Sunday News)

They pondered what to do. Jeff applied for medical assistance through the state but was turned down because he had earned too much money at his job and he and Judy owned, outright, their plot of land out in the country and the trailer that sat on it. The bills hung over their heads.

Some acquaintances told them to simply ignore the bills. Nobody pays medical bills, they told them. Just let them go. They couldn’t do that. “We were raised that you pay your bills,” Judy said. “We’ve always paid our bills.”

So they took out a home equity line of credit on their property to pay off the bills. Initially, the payments were low enough to handle, but once the introductory interest rate expired, the payments doubled and they fell behind. They had paid off their mortgage seven years ago and were looking forward to having the place free and clear for their retirement. But now, they’re just hoping they’ll be able to hang onto it. They’ve considered consulting a lawyer but have no money to pay for one.

Jeff’s employment history didn’t get much better. He had trouble finding a job. Just this week, he caught on with a small HVAC contractor but was laid off a mere two days into the job.

They are still looking at huge debt and, unless things change, and unless Jeff qualifies to collect unemployment, they are out of luck. On the positive side, Jeff currently has insurance under the Affordable Care Act. The bad news is his premium is $268 a month, a bill they have a hard time affording. They have no real choice. It’s not an option, as Jeff still has to go to medical appointments and buy prescriptions.

They’ve had to rely on the kindness of friends and neighbors. They had some Facebook friends raise $500 to help them out. They have a friend who has dropped off Giant gift cards. They rely on the food bank to put dinner on the table. They've started a GoFundMe page to raise money.

“I’ve never been in this predicament,” Jeff said. “Usually, I was the one helping other people. It sucks.”

That their predicament is not all that unusual, in a country that has great wealth, but still can’t figure out how to provide basic health care to its citizens, provides little comfort. They live simply – they still have a cathode-ray TV and their cars are 20-plus years old – and aren’t looking to strike it rich. They just want to get by.

“I’m still trying to figure it out,” Jeff said. “I don’t know how to describe it. It’s like you’re used to being behind the wheel in your life and somebody takes the steering wheel away from you.”

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Jay Lassiter smokes a rolled joint of medical cannabis at his Cherry Hill, N.J., home. Lassiter uses medical marijuana through New Jersey's legal dispensary system to help with symptoms of HIV. Jeff Lautenberger, For The York Daily Record

Jay Lassiter at home in Cherry Hill, N.J. Lassiter is HIV-positive and uses medical marijuana to alleviate his symptoms through New Jersey's legal dispensary system. Jeff Lautenberger, For The York Daily Record